Invasion of the Left Atrium by a Squamous Lung Cancer.

Abstract

Previously, he had no respiratory symptoms, until the day he came to the emergency room with sudden chest pain, with no irradiation and progressive intensity. A CT thoracic angiogram was performed and showed invasion of the left atrium (Figures 1-4). Bronchoscopy revealed in the right bronchi tree an exophytic mass with superficial vascularization and indirect signs of tumor. Biopsy confirmed a squamous lung cancer with moderate differentiation. Immunohistochemistry testing was performed and was positive for cytokeratin 5 and negative for cytokeratin 7, TTF1 and synaptophysin. This diagnosis wasn’t verified by immune staining for p63. The echocardiogram showed an enlarged left ventricle, diffuse hypo kinesia, left ventricle ejection fraction of 36%, dilatation of the left atrium (32 cm2) and right atrium (27 cm2); a hypo echoic mass was in contact with the left atrium, but without direct invasion.